final summary report - leisure and cultural services ... exercise for all campaign – physical...

Healthy Exercise for All Campaign –

Physical Fitness Test for the Community

Final Summary Report

Commissioned by Co-ordinated by

Community Sports Committee

of the Sports Commission Leisure and Cultural

Services Department

Supported by

Education

Bureau

Department of

Health

Hong Kong

Association of

Sports Medicine

and Sports

Science

Physical Fitness

Association of

Hong Kong,

China

Report submitted by

The Chinese University of Hong Kong

Department of Sports Science & Physical Education

November 2012

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【 Summary of Findings 】

1. Background

1.1 The Physical Fitness Test for the Community (the Study) was one of the events

under the Healthy Exercise for All Campaign. The Study was steered by the

Community Sports Committee of Hong Kong, and organized by the Leisure and

Cultural Services Department (LCSD). It included a series of standardized physical

fitness tests and questionnaire survey on the basis of “國民體質監測工作方案”

done by the General Administration of Sport, China (國家體育總局).

1.2 Targeted Participants were Hong Kong citizens aged 3–69. There were five age

groups, infants aged 3–6, children aged 7–12, adolescents aged 13–19, adults aged

20–59, and elderly aged 60–69.

1.3 The Study sampled over 13,000 participants through Stratified and random

sampling method in 18 districts, ended up with 8,178 valid samples.

1.4 The LCSD as the organizer of the Study appointed the Department of Sports

Science and Physical Education (SSPE) at The Chinese University of Hong Kong,

the Physical Fitness Association of Hong Kong, China (HKFPA), and MVA Hong

Kong Limited (MVA) to conduct a territory-wide community fitness survey from

April 2011 to January 2012. The SSPE research team was to assist the Government

Representative in monitoring the performance and provide consultation and

professional advice on the work of other involved parties in the Project, and oversee

the sampling method. Recommendation was made on fitness test and survey

questionnaire design, including suggestions and modifications on testing protocols

and questionnaire items, together with the format of data collection process. The

SSPE was also responsible for data processing, statistical analysis, and the results

report write-up. The HKPFA was responsible for testers training, conducting the

fitness tests for all age groups, preparing and collecting questionnaire data from

school-age groups, providing operational supporting services including safety

screening and professional advice provision. MVA was responsible for enumerators

training, conducting household interviews and inviting eligible citizens to the sports

centres nearby for physical fitness tests.

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1.5 There was a phased data collection process according to age groups. For infants and

adolescents, the working group randomly selected one kindergarten and one

secondary school in 18 districts respectively. For children, 18 primary schools were

randomly selected from four regions (H.K. Island, Kowloon, New Territories East,

and New Territories West) according to their modus operandi (direct subsidy

scheme, aided school, and private independent school) with assistance from the

Education Bureau (EDB). HKPFA was responsible for the data collection of the

three student groups. For adults and elderly, MVA and HKPFA were to conduct

household survey and follow up the fitness measurements respectively.

2. Project Objectives

2.1 The objectives of the Study were to (1) enable the individuals participants to have a

general understanding of their physical fitness condition; (2) continue building up a

physical fitness database of Hong Kong people; (3) identify the relationship

between physical exercise pattern and physical fitness of Hong Kong people; and (4)

identify priority areas for improvement to enhance the overall physical fitness of the

public.

2.2 Fitness measurements were executed by qualified HKPFA testers. The fitness data

was used to generate normative tables by gender and age group, so that people

could compare their fitness performance with the overall profile on their own.

2.3 The information about the patterns and the level of physical activity (P.A.)

participation, lifestyle, demographic information as well as attitude towards in P.A.

participation and self-perception of health-related issues were collected via

questionnaire.

2.4 According to the findings, suggestions concerning education and related supporting

policies were provided so as to raise Hong Kong people’s P.A. level and general

fitness profile.

3. Data Analysis

3.1 After collecting the data from questionnaire surveys and physical fitness tests, the

research team carried out statistical analyses, including descriptive statistics,

sampling distribution, comparisons, and correlation analysis. The relationships

between participants’ fitness levels and their exercise patterns as well as lifestyle

habits and so on were investigated.

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3.2 In the Study report, participants were being categorized into four groups (obese,

overweight, underweight, and normal) according to their body mass index (BMI).

The classification of adults and the elderly was based on the BMI criteria for Asian

established by the World Health Organization (WHO) in 2000 while infants,

children, and adolescents were classified with reference to age and gender specific

BMI criteria recommendation by the International Obesity Task Force (IOTF) in

2000 and 2007.

3.3 On the other hand, the Study grouped the participants aged 7 years or above in

terms of their P.A. level. Two reference criteria were adopted, namely “2008

Physical Activity Guidelines for Americans” (“American Indicator”)remarks 1

and

“Physical Activity Baseline Indicator” (“Baseline Indicator”)remarks 2

which was

promoted locally and by some other countries/ regions, including China, England,

and Taiwan. Participants were evaluated whether or not they met the

recommendations under the two criteria. Although there was a difference in P.A.

recommendations, research team still believed that it was necessary to conduct the

classification analysis based on both criteria. The reasons included (1) “American

Indicator” which was widely admitted and used in the field of physical education,

medicine, and public health was founded on an enormous number of scientific

evidences. It was quoted by WHO (2010) as well. The classification using a

globally-recognized reference made helped the Study report more comparable; (2)

“Baseline Indicator” which was less demanding than “American Indicator” and

easily accepted by busy Hong Kong people was promoted locally in recent years.

Therefore, research team summarized that each reference criterion had its

advantages, especially in a fast-moving place like Hong Kong. People were

encouraged to take a first step to meet “Baseline Indicator”. After enriching

cognitive level as well as physical fitness level, they were suggested to take

reference from “American Indicator” and gradually increase their P.A. level.

Remarks 1 “American Indictor”: “Active” children were those who accumulated at least 60 minutes

moderate-or-above intensity P.A. every day in a week. “Active” adolescents were those who

accumulated at least 60 minutes moderate-or-above intensity P.A. every day in a week in which

any three days involved with vigorous intensity P.A. “Active” adults and elderly were those who

accumulated at least 150 minutes moderate-or-above intensity P.A. in a week (or 75minutes

vigorous intensity P.A. or other combinations of different intensities, e.g. accumulation of 90

minutes and 30 minutes moderate- and vigorous- intensity P.A. respectively).

Remarks 2 “Baseline Indicator”: The Indicator was applied to all age groups. “Active” people were those who

participated in moderate-or-above intensity P.A. at least three days a week with accumulation of

30 minutes or above per day.

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3.4 The P.A. level of Hong Kong people was also used to compare with the one

released in the “Report for the Consultancy Study on Sports for All – Participation

Patterns of Hong Kong People in Physical Activities” in 2009 (“Sports for All

Study 2009”). The purpose of making such comparison was to understand the

change of P.A. level across the past few years. The main reason why “Sports for All

Study 2009” was chosen for comparison was that both studies adopted similar

research methodology: (1) random sampling; (2) same age groups of participants;

(3) similar assessment methods of P.A. level.

3.5 The percentages of different parameters presented in the report were calculated

from the true value before rounding. Therefore, add-ups of figures in the tables may

not be equal to the sub-total or total.

4. Infants

4.1 Participants

4.1.1 One kindergarten was selected from 18 districts respectively through

stratified randomly sampling. Each school assisted in picking one class

from three grades respectively. Infants aged 3–6 were invited to

participate in the Study.

4.1.2 There were 707 randomly selected samples of which 584 were valid

(82.6%).

4.1.3 The research team compared the sample sizes of four sub-groups (boys/

girls aged 3–4; boys/ girls aged 5–6) with the “Mid-2011 Provisional

Population Figures” published by the C&SD so as to allow necessary

weighting calculations.

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4.2 Physical Fitness Level

4.2.1 The mean values of body composition and fitness parameters were shown

in the table below.

Age 3–4 5–6

Parameters Gender Boys Girls Boys Girls

Height (cm) 104.37 103.30 114.55 113.27

Weight (kg) 17.28 16.40 21.00 20.22

BMI (kg/m2) 15.83 15.33 15.91 15.66

Seated height (cm) 58.92 58.15 63.47 62.79

Total Skinfold (Upper Arm + Calf) (mm) 16.01 17.16 16.88 18.92

Chest circumference (cm) 54.73 53.94 58.30 57.35

Resting HR (bpm) 99.14 97.52 93.91 94.85

Sit-and-reach (cm) 5.35 7.52 4.42 6.39

Walking on a balance beam (s) 17.58 18.18 8.02 8.52

Continuous jump with both feet (s) 11.42 11.35 7.58 7.69

Standing long jump (cm) 67.00 62.93 90.98 81.89

10m × 2 shuttle run (s) 8.15 8.46 6.88 7.04

Throwing a Tennis Ball (m) 3.42 2.80 5.01 4.38

4.2.2 According to the criteria suggested by International Obesity Task Force

(IOTF), 12.9% of boys and 14.1% of girls were classified as overweight or

obese (see the table below). In addition, about 20% of infants (boys:

19.3%; girls: 19.5%) were categorized as underweight. To sum up, the

prevalence of overweight and obese infants was a bit high. Close attention

should be paid to the issue.

Age Underweight Overweight Obese

Boys (%) Girls (%) Boys (%) Girls (%) Boys (%) Girls (%)

3–4 20.1 22.2 6.7 9.0 3.4 0.7

5–6 18.4 16.5 8.2 13.5 7.6 5.3

Sub-total 19.3 19.5 7.5 11.2 5.5 2.9

Total 19.4 9.3 4.2

4.2.3 Infants’ physique (height, weight, seated height, and chest circumference)

and skinfold thickness significantly increased with age.

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4.2.4 Resting HR and sit-and-reach performance (flexibility) decreased

significantly with age.

4.2.5 The performances of walking on a balance beam, continuous jump with

both feet, standing long jump, 10m × 2 shuttle run, and throwing a tennis

ball significantly got improved with age.

4.2.6 Girls had thicker skinfold and greater flexibility while boys performed

better in standing long jump and throwing a tennis ball. The results

mentioned reached significant difference.

4.2.7 Age and gender specific normative tables in quintiles and percentile ranks

were generated.

4.3 Inter-correlation between Fitness Variables

4.3.1 In both genders, moderate-to-high correlations (r = 0.608–0.830) existed

among infants’ BMI, skinfold thickness, and chest circumference.

4.3.2 There was a moderate correlation (0.400 ≤ r < 0.700) between the

performances of continuous jump with both feet and 10m × 2 shuttle run

in boys only. Other correlations are very small (r < 0.400).

4.4 Physical Activity Participation Pattern

4.4.1 The three most favourite physical activities of boys were “playing in the

playground” (80.4%), “swimming” (49.7%), and “ball games” (44.4%).

The three most favourite physical activities of girls were “playing in the

playground” (80.4%), “dance” (50.7%), and “swimming” (40.6%).

4.4.2 More than 30% of infants received exercise training (learning class) on

“cycling” (33.5%) or “swimming” (32.0%) in the past year.

4.4.3 Less than 20% of infants (17.7%) in Hong Kong performed an hour or

more of outdoor activities on average each day. The time spent on outdoor

activities could be an indicator for measuring the amount of P.A.

participation. Hong Kong infants thus were not physically active enough.

4.4.4 Only 48.5% of infants participated in P.A. with their family members at

least once per week in weekends or holidays. 31.8% of infants had P.A.

participation with family for 1 to 2 times per month. As high as 13.6% of

infants only took part in P.A. with family once several months. Even 6.1%

had none in the past year. These statistics drew our attention in the society

that parents may not be aware of the importance of having P.A. with their

children and sacrificed the time for heavy daily workload.

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4.5 Further Analysis

Relationship between Physical Fitness and Screen Time in Infants

4.5.1 In age group of 5–6, screen time was significantly correlated with resting

HR, standing long jump performance, and 10m x 2 shuttle run

performance (p<0.05).

4.5.2 Infants who accumulated two hours or more of screen time in a day had

faster resting HR, weaker leg muscular strength, lower running speed, and

longer reaction time than those who accumulated less than two hours a

day.

Relationship between the Frequency of Family Physical Activity and the Duration

of Outdoor Activity in Infants

4.5.3 The duration of outdoor activity significantly increased with the frequency

of family P.A. (boys: p < 0.05, girls: p < 0.05).

Relationship between Physical Fitness and the Duration of Outdoor Activity in Infants

4.5.4 The BMI of infants aged 3–4 who accumulated one hour or more of

outdoor activities each day was higher than those who accumulated less

than one hour at p<0.05.

4.6 Discussion & Recommendations

4.6.1 Parents and preschool organizations were recommended to perform

physical fitness assessments regularly in order to understand the change of

fitness level. Referral for children in need to appropriate professionals

could be made as soon as possible. Fitness measurements should be

comprehensive instead of only focusing on one or two items. Various

fitness parameters were suggested to be evaluated separately as they were

mainly independent against each other

4.6.2 According to the criteria recommended by the International Obesity

Taskforce (IOTF), as much as 19.4% and 13.5% of infants were

underweight and overweight or obese respectively. It reflected that

undernourishment and over-nutrition were both common in infants. It was

necessary to deliver the information about balanced diet to parents.

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4.6.3 One of the innate characteristics of infants is that they love to move

around all day long. P.A. is a major component in their daily life. The

National Association for Sports and Physical Education (NASPE) of the

United States suggested that children aged 2 years or above should

accumulate at least 60 minutes of physical activities every day. In Hong

Kong, less than 20% of infants (boys: 18.0%, girls: 17.4%) met the

recommendation in terms of outdoor activities, reflecting insufficient P.A.

Moreover, more than half of infants could not have P.A. participation with

family at least once per week. The situation drew our attention. In fact, it

is crucial to nurture children to have active lifestyle starting from early

childhood. It was suggested that preschool organizations and parents

should share the responsibilities in modifying health behaviours of infants.

For example, kindergartens may incorporate minimum 20-minute physical

games into their curriculum every day while parents arranged not less than

40-minute P.A. in before-school or after-school periods. Formal training

should be provided to kindergarten teachers on how to teach physical

movement of their students. In addition, government and related

stakeholders may think about offering more workshops and fun days so as

to encourage and educate parents to arrange more family-based P.A.

4.6.4 “Playing in playgrounds”, “swimming”, and “ball games” were the most

favourite physical activities of infants. Related stakeholders should

continue to sustain the resources in these activities, so as to increase the

opportunities for infants’ participation.

5. Children

5.1 Participants

5.1.1 Primary schools were selected through stratified randomly sampling

according to their locations and modus operandi. Children aged 7–12 were

invited to participate in the Study.

5.1.2 A total of 18 primary schools were participated, 4 from H.K. Island, 5

from Kowloon, 5 from New Territories West, and 4 from New Territories

East. There were 2,803 randomly selected samples of which 2,723 were

valid (97.1%).





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in the table below.

Age 7–9 10–12


Height (cm) 130.68 130.05 144.71 146.18

Weight (kg) 30.11 28.71 40.48 39.70

BMI (kg/m2) 17.41 16.80 19.11 18.39

Seated height (cm) 70.26 69.88 75.79 77.25



Resting Systolic BP (SBP, mmHg) 104.62 103.91 108.88 109.72

Resting Diastolic BP (DBP, mmHg) 63.97 64.20 66.51 67.36

Resting HR (bpm) 87.53 90.34 81.56 86.28

Sit-and-reach (cm) 1.13 3.84 -1.15 4.76

Hand Grip (kg) 23.21 21.30 32.88 32.80

1-min Sit-ups (rep) 17.07 16.02 22.09 21.53

Standing Long Jump (cm) 116.24 105.16 133.62 120.72

15m PACER (turns) 13.20 12.31 19.97 17.57



obese (see the table below). In addition, 7.8 % of boys and 9.9% of girls

were categorized as underweight.



7–9 8.0 10.1 18.2 16.6 10.0 6.2

10–12 7.6 9.8 22.4 19.7 10.2 3.2

Sub-total 7.8 9.9 20.5 18.3 10.1 4.5

Total 8.8 19.5 7.4

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5.2.3 From the table below, 4.1% of primary school students were identified

with the risk of hypertension remarks 3

. Although the percentage is low,

caution should be raised as healthy children at young age should not have

such chronic disease.

High Blood Pressure Symptom SBP ≥140mmHg or / and DBP ≥ 90mmHg

Age Boys (%) Girls (%) Total (%)

7–9 4.2 4.5 4.3

10–12 4.1 3.7 3.9

Total 4.2 4.1 4.1

5.2.4 Children’s height, weight, BMI, seated height, skinfold thickness, chest

circumference, as well as resting SBP and DBP significantly increased

with age.

5.2.5 Resting HR decreased significantly with age.

5.2.6 The performances of 1-min sit-ups, standing long jump, and 15m PACER

significantly got improved with age.

5.2.7 Girls had higher resting HR and flexibility but smaller percent body fat

while boys performed better in standing long jump, and 15m PACER. The

results mentioned reached significant difference.

Remarks 3 Such classification was conducted according to resting SBP ≥140 mmHg or/and DBP ≥ 90 mmHg.

In fact, BP was correlated with students’ age, height, and gender. Research team also took the age-,

height-, and gender-adjusted criteria recommended by National High Blood Pressure Education

Program (NHBPEP) Working Group and Bureau of Health Promotion, Department of Health

(Taiwan) as well as Taiwan Society of Internal Medicine into account. Children with BP ≥ 95

percentile values were regarded as having high BP symptom (see the table below).

Age Meet at least 1 of the following conditions High Blood Pressure Symptom

Resting SBP (mmHg) Resting DBP (mmHg) Boys (%) Girls (%) Total (%)

7–9 ≥ 122 ≥ 78 19.1 17.5 18.3

10–12 ≥ 126 ≥ 82 16.9 19.0 17.9

Total 17.8 18.3 18.1

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5.3.1 In both genders, high correlations (r ≥ 0.700) existed among children’s

BMI, skinfold thickness, and chest circumference.

5.3.2 In boys, a negative moderate correlation existed between skinfold

thickness and 15m PACER (r = -0.430), reflecting that fat children may

have smaller leg muscular strength and cardiovascular fitness. On the

other hand, there were moderate correlations (r = 0.404–0.479) among

15m PACER, 1-min sit-ups, and standing long jump. Other correlations

were very small (r < 0.400).

5.3.3 In girls, a moderate correlation existed between chest circumference and

handgrip strength (r = 0.451), reflecting children with large chest cavity

may have greater strength at upper limbs. In addition, there was a

moderate correlation between standing long jump and 15m PACER (r =

0.415). Other correlations were very small (r < 0.400).


were generated.

5.4 Health-related Lifestyle

5.4.1 About 80% of children (81.1%) indicated that they had sufficient or very

sufficient P.A.

5.4.2 According to the “American Indicator”, children who accumulated at least

60 minutes moderate-or-above intensity P.A. every day in a week were

classified as physically active. To facilitate the further analysis, the

original categories “active” and “inactive” were subdivided into “active”,

“some active”, and “sedentary” (see the table below). Only 9.5% of boys

and 7.0% of girls in the study met the recommendation based on the

amount of P.A. they reported. There was substantial discrepancy between

children’s self-evaluation and the reality. Therefore it is suggested that

school-aged children may not be aware of the minimal requirement of P.A.

during childhood. Education should be reinforced to alert students about

the related requirement so as to promote active lifestyle in younger ages.

Category

(with modification)

Number of days accumulated at least

60 minutes moderate-or-above

intensity physical activity in a week

Boys

(%)

Girls

(%)

Total

(%)

III Active 7 days 9.5 7.0 8.3

II Some active 1–6 days 69.9 72.2 71.0

I Sedentary <1 day 20.5 20.9 20.7

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5.4.3 Furthermore, a classification according to the “Baseline Indicator” was

shown in the table below. Children who participated in moderate-or-above

intensity P.A. at least three days a week with accumulation of 30 minutes

or above per day were classified as physically active. About half of

children (51.8%) did pass the mark. Boys had larger proportion of being

“active” than girls (54.7% vs. 48.7%). The use of different standard made

no difference to the discrepancy between what the children assessed for

themselves and the real situation.

Category Accumulation of moderate-or-above


Boys

(%)

Girls

(%)

Total

(%)

III Active ≥ 90 minutes 54.7 48.7 51.8

II Some active 30–89 minutes 35.7 44.6 40.0

I Sedentary < 30 minutes 9.6 6.7 8.2

5.4.4 In the past year, approximately 80% of children had taken part in sports

training as extra-curricular activities with “ball games” being the most

favourite sports (68.1%), followed by “swimming” (48.8%) and “track

and field” (42.0%).

5.4.5 It was found that about 40% of children spent more than 5 hours on

sedentary activities (including study and recreation) after school.

5.4.6 17.9% of children slept less than 7 hours per day while the percentage of

those slept for 9 hours or more per day was 32.0%.

5.4.7 Over 80% of children (83.5%) had an intake of at least a bowl of

vegetables everyday. Also, a similar proportion of children (84.8%) had an

intake of at least one fruit daily. 64.8% of children drank at least a cup of

milk beverage everyday. It was found that most of the children met the

recommendations on the food pyramid made by the Department of Health.

However, the perception of the importance of consuming vegetables, fruits,

and milk products was not studied in this study. Children may be able to

meet the requirements only because their menus were set by their schools

which provided lunch box or other care takers.

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5.4.8 Around a quarter of children took high calorie food 3 times or more in a

week, such as “chocolates or candies” (27.0%), “soft drinks, paper-packed

drinks or canned drinks” (24.8%), and “cup noodles or instant noodles

(23.5%)” (see the table below).

Foods/ Drinks Boys

(%)

Girls

(%)

Total

(%)

Chocolates or candies 26.0 28.1 27.0

Soft drinks, paper-packed drinks or canned drinks 27.5 21.9 24.8

Cup noodles or instant noodles 27.7 19.0 23.5

Deep fried foods (e.g. fried chicken, pork chop cutlet) 22.4 14.8 18.7

Street snacks (e.g. fish balls, siu mai) 19.6 14.2 17.0

Potato chips 15.4 11.6 13.6

Yogurts 12.5 12.6 12.5

Ice-creams 11.5 11.4 11.5

Pizzas 10.7 6.8 8.8

5.5 Attitudes and Feelings toward Physical Activity

5.5.1 The three major reasons adduced by the children for poor physical health

were “inadequate sleep” (62.9%), “imbalance diet” (47.2%), and “too

much homework” (38.8%). “Inadequate physical activity” was accounted

for 38.0%。

5.5.2 On a scale of 1 to 4, the three most important benefits associated with P.A.

participation were “P.A. helps maintain physical health” (mean rank: 3.57),

“P.A. develops various physical skills” (mean rank: 3.45), and “P.A. helps

control body-weight” (mean rank: 3.42).

5.5.3 On a scale of 1 to 4, the three attitude statements with highest level of

agreement were “I like P.A.” (mean rank: 3.61), “P.A. is very interesting”

(mean rank: 3.53), and “P.A. participation makes me feel happy” (mean

rank: 3.52). The results reflected that interesting physical activities which

brought children happiness and aroused their emotional state could

increase their participation.

5.5.4 On a scale of 1 to 3, the three major barriers cited to participation of P.A.

were “inclement weather” (mean rank: 2.01), “too much homework”

(mean rank: 1.99), and “being tired” (mean rank: 1.86).

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5.5.5 Among those 59.5% of children who had the experience in playing

electronic motion-sensing games, 81.5% of them agreed that those games

has induced a greater interest in sports participation, while about half of

them (50.9%) spent an hour or more per day in playing electronic motion-

sensing games in the past week.


Relationship between Physical Fitness and Physical Activity Level (“American

Indicator”) in Children

5.6.1 An increase in P.A. participation was highly associated with better

muscular strength and cardiovascular fitness at significant level. Related

test items included handgrip, 1-min sit-ups, standing long jump, and 15m

PACER.

5.6.2 “Active” boys demonstrated 8.4% and 19.8% better performance in

standing long jump and 15m PACER respectively than “sedentary” boys

who also demonstrated 9.0% and 14.7% lower performance in handgrip

and 1-min sit-up than “some-active” boys.

5.6.3 In girls, major difference mainly existed between “some-active” children

and “sedentary” children.

Relationship between Screen Time and Physical Activity Level (“American

Indicator”) in Children

5.6.4 When children’s screen time (watching TV/ movies, playing electronic

games, using computer or web-surfing) increased, their P.A. level

significantly dropped.

5.6.5 In boys, there were a higher proportion of children who spent more than 3

hours on screen activities during school days classified as “sedentary”

than those with 3-hour-or-less screen time (32.0% vs. 18.1%).

5.6.6 In girls, there were fewer children who spent an hour or above on screen

activities classified as “active” than those with less than an hour screen

time (5.3% vs. 9.7%).

Relationship between Screen Time and Body Mass Index in Children

5.6.7 When children’s screen time increased, their BMI significantly rose.

5.6.8 Boys who spent 2 hours or above on screen activities during school days

had greater BMI than those without screen time.

5.6.9 Girls who spent more than 3 hours on screen activities had greater BMI

than those with less than 1 hour or no screen time.

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Relationship between Physical Fitness and Sleeping Time in Children

5.6.10 There was a significant difference in fitness level between groups of

children having different sleep times.

5.6.11 Children who slept for 7 to 8 hours daily performed better in standing long

jump and 15m PACER than those who slept less or more.

5.6.12 In 1-min sit-ups test, boys with 7 to 8 sleeping hours daily also had better

performance whereas girls with 9 sleeping hours or more showed worse

performance than those who slept less.

5.6.13 In handgrip test, children who slept 9 hours or more demonstrated smaller

forearm strength.

Relationship between Parent’s Exercise Frequency and Children’s Physical

Activity Level (“American Indicator”)

5.6.14 There were significant differences in children’s P.A. levels between

groups of parents with various exercise frequencies per week. Children

tended to be more physically active if their fathers or mothers were more

physically active.

5.6.15 When fathers did exercise at least 6 times per week, 24.1% of their sons

and 16.2% of daughters were “active”. The proportions were higher than

those whose fathers had no exercise in a week (boys: 7.5%, girls: 4.9%).

5.6.16 When mothers’ exercise frequency reached 6 times per week, 23.6% of

their sons and 15.0% of daughters were “active”. The proportions were

also higher than those whose mothers had no exercise in a week (boys:

6.5%, girls: 5.4%).

5.6.17 In fact, there were 34.9% of fathers and 37.2% of mothers who did not

participate in any form of exercise. Moreover, as much as 62.9% of family

did not manage to have regular family activities in sports during weekends

or holidays (at least once a week) in the past year.

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Comparison of Physical Activity Level across Years

5.6.18 The results from the table below showed the comparison of P.A. level

based on the “Baseline Indicator” between “Sports for All Study 2009”

and the current study. There was no significant difference in P.A. level

between the two years.

Study P.A. Level Chi-square Test

p-value Some active, Sedentary (%) Active (%)

2009 50.8 49.2 0.147

2011 47.7 52.3

5.6.19 The P.A. level based on “American Indicator” proposed by USDHHS was

also compared between “Sports for All Study 2009” and the current study

(see the table below). More children (9.0%) met the guidelines

requirement in the current study, higher than the proportion reported in

Sports for All Survey (5.7%). The difference reached statistically

significance. Such results were mainly attributed to a significant

increasing percentage of girls being classified as “active” from 3.7% to

7.7%.



2009 94.3 5.7 0.006 @

2011 91.0 9.0 @

Significant difference at p ≤0.05


5.7.1 To allow children to have full understanding of how much P.A. is

recommended for their age, corresponding frequency, duration, and

intensity under the two P.A. indictors should be explained clearly to them.

5.7.2 According to the criteria suggested by the International Obesity Taskforce

(IOTF), 19.5% and 7.4% of children were overweight and obese

respectively. Other than insufficient P.A. participation, children may

suffer from over-nutrition. Related stakeholders are advised to publicize

the impact of eating junk food (generally referring to fast food and low

nutritional value food) on health.

17/41

5.7.3 To alleviate the main constraint “inclement weather” to P.A. participation,

it is suggested that related stakeholders establish more highly-accessible

indoor activity facilities and play rooms suitable for children aged 7 to 12.

5.7.4 To awaken children’s interests in do exercise and raise their P.A. levels,

schools and families are recommended to arrange diversified exercise

games in groups so as to provide children with interesting and delighted

experiences.

5.7.5 Parents’ and children’s P.A. levels were found to be highly associated.

Parents’ positive attitude toward P.A. participation had great influence on

children. It is suggested to let parents obtain more information about the

benefits of developing regular exercise habit and encourage them to

organize family-based P.A. functions.

5.7.6 Electronic screen-based motion-sensing games become more popular

nowadays. They involve intensive body movements that simulate

biomechanics of various sport activities in reality. Electronic motion-

sensing games are thought to be one of the innovative and attractive

means which could be supplementary to traditional mode of exercise

promotion. Certainly, more evidences should be explored to evaluate their

effectiveness. Do playing electronic motion-sensing games increase

overall fitness level? Are cognitive and psychosocial effects brought by

playing electronic motion-sensing games identical to those of actual P.A.

or sports participation? Are any safety measures such warm-up and cool-

down activity incorporated in electronic motion-sensing games?

6. Adolescents

6.1 Participants

6.1.1 One secondary school was selected from 18 districts respectively through

stratified randomly sampling. Adolescents aged 13–19 were invited to

participate in the Study.

6.1.2 There were 2,805 randomly selected samples of which 2,517 were valid

(89.7%).





18/41



in the table below.

Age 13–15 16–19


Height (cm) 165.46 157.26 170.99 158.90

Weight (kg) 55.83 49.56 62.30 51.06

BMI (kg/m2) 20.32 20.02 21.27 20.19

Seated height (cm) 86.75 83.98 90.76 85.12



Percent Body Fat 18.23 24.08 14.40 22.93

Resting Systolic BP (SBP, mmHg) 115.46 107.20 122.48 107.28

Resting Diastolic BP (DBP, mmHg) 69.11 66.70 73.56 66.70

Resting HR (bpm) 81.24 84.91 76.15 83.07

Sit-and-reach (cm) -0.43 6.84 2.48 7.81

Hand Grip (kg) 58.37 40.65 71.97 42.43

1-min Sit-ups (rep) 28.61 22.03 30.62 22.58

Push-ups (rep) 9.51 6.19 15.06 6.68

Standing Long Jump (cm) 169.44 131.31 187.75 134.93

15m PACER (turns) 38.05 21.77 43.50 22.23



obese (see the table below). In addition, 15.5 % of boys and 21.0% of girls

were categorized as underweight.



13–15 12.8 13.4 15.0 9.5 7.1 2.4

16–19 17.3 26.3 11.9 5.8 4.0 1.8

Sub-total 15.5 21.0 13.2 7.4 5.3 2.1

Total 18.2 10.3 3.7

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6.2.3 According to SBP ≥ 140mmHg or / and DBP ≥ 90mmHg, 7.5% of boys

and 1.2% of girls were identified with the risk of hypertension remarks 4

(see

the table below).

High Blood Pressure Symptom SBP ≥140mmHg or / and DBP ≥ 90mmHg

Age Boys (%) Girls (%) Total (%)

13–15 3.4 1.4 2.4

16–19 10.3 1.1 5.8

Total 7.5 1.2 4.4

6.2.4 The exercise performances of handgrip, 1-min sit-ups, push-ups, standing

long jump, and 15m PACER significantly got improved as age advanced.

6.2.5 Boys had greater height, weight, seated height, chest circumference, and

resting SBP and DBP than girls while girls possessed higher skinfold

thickness, percent body fat, and resting HR than boys. The results

mentioned reached significant difference.

Remarks 4 Such classification was conducted according to resting SBP ≥140 mmHg or/and DBP ≥ 90 mmHg.

In fact, BP was correlated with students’ age, height, and gender. Research team also took the age-,

height-, and gender-adjusted criteria recommended by National High Blood Pressure Education

Program (NHBPEP) Working Group and Bureau of Health Promotion, Department of Health

(Taiwan) as well as Taiwan Society of Internal Medicine into account. Adolescents with BP ≥ 95

percentile values were regarded as having high BP symptom (see the table below).

Age Meet at least 1 of the following conditions High Blood Pressure Symptom

Resting SBP (mmHg) Resting DBP (mmHg) Boys (%) Girls (%) Total (%)

13–15 ≥ 136 ≥ 86 8.3 2.4 5.4

16–19 16–18 ≥ 142 ≥ 92

7.5 0.6 4.1 19 ≥ 140 ≥ 90

Total 7.8 1.3 4.6

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6.3.1 In both genders, moderate-to-high correlations (r = 0.625–0.897) existed

among adolescents’ BMI, skinfold thickness, and chest circumference.

There were also moderate correlations between resting SBP and BMI

(boys: r = 0.478, girls: r = 0.423) and chest circumference (boys: r = 0.467,

girls: r = 0.386).

6.3.2 In boys, moderate correlations were found between body compositions

and exercise performances (chest and handgrip: r = 0.402, skinfold

thickness and 15m PACER: r = -0.408, and skinfold thickness and

standing long jump: r = -0.422). Other correlations are very small (r <

0.400).

6.3.3 On the other hand, the exercise performances of 1-min sit-ups, push-ups,

15m PACER, and standing long jump in boys were moderately inter-

correlated (0.400 ≤ r < 0.700) except for the associations between 1-min

sit-ups and 15m PACER (r = 0.341) and standing long jump (r = 0.398).

In girls, a moderate correlation was shown only between 15m PACER and

standing long jump (r = 0.471). No other moderate-or-above inter-

correlations were found.


were generated.

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6.4.1 According to the “American Indicator”, adolescents who accumulated at

least 60 minutes moderate-or-above intensity P.A. every day in a week in

which any three days involved with vigorous intensity P.A. were classified

as physically active. To facilitate the further analysis, the original

categories “active” and “inactive” were subdivided into “active”, “some

active”, and “sedentary” (see the table below). Only 12.8% of boys and

4.2% of girls in the study met the recommendation based on the amount of

P.A. they reported.

Category

(with modification) P.A. Level

Boys

(%)

Girls

(%)

Total

(%)

III Active

Accumulation of at least 60 minutes

moderate-or-above intensity P.A.

everyday in a week in which any

three days involved with vigorous

intensity P.A.

12.8 4.2 8.4

II Some active

Accumulation of at least 10 minutes

but less than 60 minutes moderate-

or-above intensity P.A. everyday in

a week

47.6 41.9 44.7

I Sedentary

Accumulation of less than 10

minutes moderate-or-above intensity

P.A. everyday in a week

39.6 53.9 46.9

6.4.2 On the other hand, a classification according to the “Baseline Indicator”

was shown in the table below. Adolescents who participated in moderate-

or-above intensity P.A. at least three days a week with accumulation of 30

minutes or above per day were classified as physically active. 42.3% of

adolescents were “active” whereas 28.9% of adolescents were “sedentary”,

20.7 percent points higher than the prevalence in children (8.2%). 50.1%

of boys were “active”, 15.9 percent points higher than the prevalence in

girls.



Boys

(%)

Girls

(%)

Total

(%)




22/41

6.4.3 The three major extra-curricular activities during weekend were “friends

gathering” (61.5%), “sports” (40.5%), and “visual/ audio entertainment”

(35.0%). In girls, the top three activities were “friends gathering” (64.0%),

“shopping” (48.1%), and “visual/ audio entertainment” (44.6%).

6.4.4 A majority of adolescents (boys: 62.6%, girls: 60.4%) felt that homework

and studying was generally acceptable. Almost one-third of adolescents

(boys: 30.3%, girls: 36.7%) felt very hard.

6.4.5 During school days, a majority of adolescents (boys: 81.0%, girls: 80.2%)

slept at least 6 but less than 9 hours. 8.8% of boys and 14.4% of girls slept

less than 6 hours whereas 10.2% of boys and 5.4% of girls slept over 9

hours.

6.4.6 Senior secondary students (boys: 7.12 hours, girls: 6.74 hours) slept less

than junior secondary students (boys: 7.64 hours, girls: 7.32 hours), which

may reflect academic pressure in senior secondary classes. On the other

hand, girls slept less than boys during school days but slept more than

boys during non-school days

6.4.7 25.7% of adolescents spent 3 hours or more on screen activities (including

watching TV, using cell phone and computer, or playing video games) for

an average day.

6.5 Physical Activity Habits and Altitude & Preferences towards Physical Activities

6.5.1 The three most popular sports activities were “ball games” (75.1%), “ice

skating or roller skating” (24.8%), and “swimming” (24.7%).

6.5.2 The three major reasons adolescents adduced for poor physical conditions

were “insufficient sleep” (75.5%), “insufficient sports training” (55.8%),

and “stress” (34.2%).

6.5.3 There were 56.9% of boys and 28.3% of girls who really liked to attend

P.E. lessons. Only 5.0% and 10.9% of boys and girls respectively disliked

the lessons. The rest of them included “fairly liked” and “no comment”.

6.5.4 68.3% of adolescents said that they would participate or actively

participate in sports activities.

6.5.5 The three major reasons for participating in sports activities were “raising

ability on sports” (55.3%), “health strengthening/ prevention or cure of

sickness” (51.3%), and “releasing pressure and emotions” (38.7%).

“Keeping fit” was the fourth popular reason (36.3%) in girls, 15.4 percent

points higher than boys.

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6.5.6 The three major barriers to sports activities participation were “not

interested” (52.3%), “lazy” (45.2%), and “lack of spare time” (44.3%).

6.5.7 The three major reasons for participating in distance run training were

“raising ability on sports” (55.8%), “health strengthening/ prevention or

cure of sickness” (47.3%), and “releasing pressure and emotions” (27.0%).

The distribution was similar to the reasons for participating in sports

activities.

6.5.8 The three major barriers to distance run training participation were “tired”

(58.8%), “not interested” (55.0%), and “lazy” (35.7%).

6.5.9 The three major reasons for participating in strength training were “raising

ability on sports” (53.1%), “keeping fit” (48.3%), and “health

strengthening/ preventing or cure of sickness” (47.3%).

6.5.10 The three major reasons for not participating in strength training were “not

interested” (52.4%), “tired” (46.2%), and “lazy” (35.3%). The reasons

were the same as not participating in distance run.

6.5.11 40.8% of boys’ parents and 30.6% of girls’ parents always or sometimes

recommended their children to reduce sport activities for studies.


Main Effects and Interaction Effect of Gender and Age-Groups on Physical Fitness

6.6.1 In 2-way ANOVA, significant main effects (age-groups and gender) and

interaction effect (gender × age-groups) were found on physical fitness.

For exercise measurements, boys performed better in handgrip, 1-min sit-

ups, push-ups, standing long jump, and 15m PACER than girls except for

the sit-and-reach test.

6.6.2 The overall fitness level significantly increased with age in both genders

with boys showing a greater improvement than girls.


Indicator”) in Adolescents

6.6.3 Various P.A. levels were not significantly associated with the changes in

BMI, percent body fat, and chest circumference in both genders. It may

reflect large variations of growth factors between individuals at puberty

stage.

24/41

6.6.4 Nevertheless, there were significant relations between advancing P.A.

levels and decreasing resting HR as well as enhancing other exercise

performances (sit-and-reach, 1-min sit-ups, push-ups, handgrip, standing

long jump, and 15m PACER). Similar findings were found for both boys

and girls.

Influence of Parental Education Level on Fitness Parameters in Adolescents

6.6.5 In fathers with tertiary education attainment, their sons had smaller chest

circumference and forearm strength but lower BMI and greater

cardiovascular fitness in terms of better performance in 15m PACER test.

Girls whose fathers attained tertiary education level possessed higher

abdominal endurance and cardiovascular fitness.

6.6.6 In mothers with primary-or-below education attainment, their sons had

greater flexibility, forearm strength, and muscular endurance at shoulders,

upper back and pectorals. There was no significant difference found in

fitness parameters among various mother’s education levels in girls.

Relationship between Parents’ and Adolescents’ Physical Activity Levels

6.6.7 Significant differences were found between adolescents’ and fathers’ P.A.

levels. The P.A. levels of boys and girls with active father (frequency of

exercise training ≥ 3 per week) would have respectively about 38% and

96% higher in terms of MET-minute than those with sedentary father

(frequency of exercise training < 1). Active mothers were found to be

associated with more physical activities in girls.

6.6.8 In other words, adolescents tended to be more active if the parents were

more active. However, 47.5% of fathers and 52.1% of mothers did not

take part in exercise training in the past year. Moreover, as high as 77.0%

of adolescents did not participate in P.A. with their families regularly (at

least once per month).

Relationship between Screen Time and Physical Fitness in Adolescents

6.6.9 Adolescents were grouped according to the amount of screen time. Boys

who spent 3 hours or more on screen activities had poorer flexibility and

cardiovascular fitness than those having less than 3-hour screen activity.

Furthermore, they also were found to have lower muscular endurance

(abdomen, shoulders, upper back, and pectorals) and strength at lower

limbs than those with less than 2 hours on screen activities. There was no

significant difference in fitness parameters among various amount of

screen time in girls.

25/41




and the current study. The proportion of “active” adolescents dropped

significantly from 48.6% to 42.1% in these two years. Such results were

mainly attributed to a significant decreasing percentage of boys being

classified as physically active from 57.5% to 50.1%.



2009 51.4 48.6 0.001 @

2011 57.9 42.1 @


6.6.11 The comparison analysis of P.A. levels based on the “American Indicator”

was not available as the data collected from the two studies could not be

matched.

Preliminary Study on the “Sport For All Day”

6.6.12 Close to half of adolescents (45.2%) adolescent heard about the “Sport for

All Day” organized by the LCSD to provide Hong Kong people with a

series of free recreation and sports programmes in the past two years

(2010, 2011). No significant difference was observed between genders as

shown in the table below.

Heard about the “Sport

For All Day” Before Boys (%) Girls (%) Total (%)

Chi-square Test

p-value

Yes 44.7 45.7 45.2 0.607

No/ Not sure 55.3 54.3 54.8

6.6.13 32.3% of the respondents who were aware of the “Sport for All Day”

participated in the event. There was a significant difference between

genders that more boys took part in the event, 7.2 percent points higher

than girls as shown in the table below.

Participation in the

“Sport For All Day” Boys (%) Girls (%) Total (%)

Chi-square Test

p-value

Yes 35.8 28.6 32.3 0.009 @

No/ Not sure 64.2 71.4 67.7

@ significant difference at p ≤0.05

26/41

6.6.14 As much as 67.4% of “Sport for All Day” participants thought that their

interests in sports and P.A. could be raised through the participation. A

significant difference was found between genders as shown in the table

below. More boys (71.8%) had such thought than girls (61.9%).

Increase Interests in

Sports and P.A. Boys (%) Girls (%) Total (%)

Chi-square Test

p-value

Yes 71.8 61.9 67.4 0.042 @

No 28.2 38.1 32.6



6.7.1 In the current study, a majority of the physical fitness parameters showed

significant difference between age groups of 13–15 and 16–19. Gender

difference was also found in both age groups. This reflected the growth

spurt in physical development during puberty. Physical education

curriculums (e.g. exercise intensity, equipment disposal, and safety

measures) in schools are recommended to cater for the growth needs.

Schools were also suggested to take reference from “Physical Education

Key Learning Area Curriculum Guide (2002)” published by the HK

Curriculum Development Council so as to provide adolescents with

diversified learning experiences through a series of physical activities.

6.7.2 According to the criteria suggested by the International Obesity Taskforce

(IOTF), 18.5% of boys and 9.4% of girls were overweight or obese. On

the other extreme, 15.5% of boys and 21.0% of girls were underweight.

Boys tended to encounter overweight problem while girls tended to have

underweight problem. One possible reason was the promotion of

“Thinness is beauty” in girls by mass media. It was suggested that related

stakeholders proactively publicize the correct concepts of achieving a

healthy body weight as well as how to gain/ lose weight in a proper way.

Adolescents were encouraged to keep track on their own weight and

percent body fat.

27/41

6.7.3 Findings revealed that more than 30% of parents (35.8%) frequently or

occasionally recommended their children to reduce sport activities for

studies. It is believed that adolescents may treat studies as a higher priority

so as to satisfy the traditional expectations of parents and social norms.

The stress from studying was not that little in adolescents. An increase in

study stress may be one of the reasons for the decrease in P.A.

participation. Therefore related stakeholders should work together to find

solutions in order to mitigate the problems and promote healthier lifestyle

other than academic pursuit alone. The benefits of engaging in P.A. should

not only be promoted to students, but should also be emphasized to their

parents who would be the role model to show more active lifestyle to their

children. Family activities in sports and exercises were encouraged.

6.7.4 With reference to the key barrier “not interested” to sports activities

participation, great variety of sports content, such as cycling, sailing,

canoeing, and bowling, etc., should be introduced to adolescents. “Ball

games”, “ice skating or roller skating”, and “swimming” may also be

continuously promoted with corresponding input of resources as they were

reported to be the most popular sports.

6.7.5 As can be seen from the survey results, 62.8% of adolescents chose

“friends gathering” as their major extra-curricular activities during

weekend. “No company” was the fifth place of the reasons for not

performing sports activities. Close to 20% of adolescents (19.7%)

regarded it as a key factor. It is possible that if the norms of peer group

prefer sedentary activities, active adolescents are likely to conform to

these peer norms and become less active, vice versa. Peer group

intervention is therefore suggested to be one of the effective strategies to

promote P.A. in adolescents.

7. Adults & the Elderly

7.1 Participants

7.1.1 After a try-out test for Hong Kong residents aged 20 to 69 was

implemented, a Territory-wide Physical Fitness Test for the same target

group was conducted in 18 districts, from April 2011 to January 2012. To

begin with, Hong Kong residents were stratified randomly selected for a

face-to-face interview, then respondents were invited to attend fitness

assessments in a sports centre near their home by appointment. To

complete all the field fitness testing, fifty-seven different sports centres

provided by the LCSD and 270 testing sessions were utilized.

28/41

7.1.2 7,591 households accepted the interview which involved 15,013

household members. There were 2,354 sets of valid data (15.7%) who

completed both questionnaire survey and physical fitness tests.

7.1.3 Although the sampling percentages of middle-aged adults (age: 40–59)

and the elderly (age: 60–69) were close to the actual population

distribution ratio, young adults (age: 20–39) contributed a relatively small

portion for both genders and diverged from the sampling requirement. The

research team compared the sample sizes of sub-groups with the “Mid-

2011 Provisional Population Figures” published by the C&SD so as to

allow necessary weighting calculations.

29/41



in the table below.

Age 20–39 40–59 60–69

Parameters Gender Men Women Men Women Men Women

Body Height (cm) 171.32 158.25 167.91 156.10 165.46 153.81

Body Weight (kg) 69.74 53.70 68.91 56.92 65.24 57.78

BMI (kg/m2) 23.72 21.44 24.41 23.35 23.81 24.43

Chest Circumference (cm) 91.85 83.32 92.98 87.31 91.37 89.12

Waist Circumference (cm) 82.97 71.18 86.36 77.33 86.83 82.18

Hip Circumference (cm) 95.15 91.52 94.64 94.09 93.05 95.72

Skin

fold

Thic

knes

s

Upper Arm (mm) 11.35 16.43 9.95 17.68 9.45 17.65

Subscapular (mm) 16.79 16.71 18.40 20.47 17.13 20.34

Abdomen (mm) 21.31 20.08 22.18 22.89 20.53 24.29

Chest (mm) 11.77 ------ 13.58 ------ 13.29 ------

Suprailiac (mm) ------ 16.03 ------ 18.85 ------ 19.54

Thigh (mm) 13.28 23.20 12.01 23.82 10.95 21.38

Resting HR (bpm) 74.85 75.63 74.29 74.68 73.75 72.51

Resting Systolic BP (mmHg) 124.31 110.54 129.16 123.08 135.02 132.63

Resting Diastolic BP (mmHg) 78.05 70.06 81.89 75.40 80.37 75.49

3-min Step Test (Post Exercise HR) 143.85 145.91 132.93 144.07 ------ ------

3-min Step Test (Recovery HR) 122.13 121.77 113.96 119.54 ------ ------

Sit-and-reach (cm) -3.01 2.81 -2.58 3.22 -4.80 1.81

Hand Grip (kg) 77.94 45.56 74.47 43.46 66.15 38.77

1-min Sit-up (rep) 25.00 17.99 ------ ------ ------ ------

Push-up (rep) 17.07 9.17 ------ ------ ------ ------

Vertical Jump (cm) 36.16 22.74 ------ ------ ------ ------

Closed Eyes Balance Stand (s) 39.31 32.23 15.53 14.42 9.80 8.76

Reaction Time (s) 0.4076 0.4623 0.4504 0.5033 0.5134 0.5543

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7.2.2 According to BMI classification laid down by WHO, 14.0% of young

women were regarded as underweight (see the table below). The

proportions of overweight and obese individuals increased in the middle-

aged. The prevalence of women experienced the obesity problem kept on

rising. 40.3% of middle-aged men and 40.8% of elderly women were

obese.

Age

Underweight (%) Normal (%) Overweight (%) Obese (%)

BMI < 18.5 18.5 ≤ BMI< 23 23 ≤ BMI < 25 BMI ≥ 25

Men Women Men Women Men Women Men Women

20–39 6.8 14.0 39.1 60.1 19.3 13.3 34.8 12.6

40–59 2.1 3.5 31.4 48.1 26.2 21.7 40.3 26.7

60–69 5.4 3.0 31.7 37.1 28.7 19.1 34.2 40.8

Sub-total 4.3 7.9 34.4 52.0 23.9 17.8 37.3 22.3

Total 6.3 44.0 20.6 29.1

7.2.3 Men and women with waist circumference greater than 90cm and 80cm

respectively were classified as having central obesity. Over a quarter of

adults and the elderly (men: 28.1%, women: 25.9%) encountered related

issue as shown in the table below.

Central Obesity (%)

Waist Circumference > 90cm > 80cm Total

Age Men Women

20–39 22.2 10.8 15.7

40–59 31.4 32.7 32.1

60–69 33.1 55.1 44.0

All 28.1 25.9 26.9

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7.2.4 There was a significant increase in prevalence of hypertensive response

from young to old adulthood as shown in the table below. 16.4% and 6.3%

of young men and women suffered from the risks of hypertension. The

percentage of elderly men with high blood pressure symptom was

approximately 2.4 times the young men. A 5.6-time expansion even

existed in women.

Age High Blood Pressure Symptom (%)

Men Women Total

20–39 16.4 6.3 10.6

40–59 29.0 19.4 23.9

60–69 40.0 35.1 37.6

All 25.7 15.6 20.2


7.3.1 Among 14 fitness parameters, high correlations (r ≥ 0.700) existed

between BMI and skinfold thickness (except for elderly women), resting

SBP and DBP (except for the elderly), and step test post-exercise HR and

recovery HR (except for young women). Moderate correlations (0.400 ≤ r

< 0.700) were only found among a few parameters. Other correlations are

very small (r < 0.400) or close to zero.

7.3.2 The overall result suggests that most fitness parameters are quite unique

and independent to each other. Hence, when evaluating physical fitness,

various aspects have to be included for a completed fitness evaluation.


were generated.

32/41


7.4.1 The research team took reference from the International Physical Activity

Questionnaire (IPAQ) to help transform the time spent on moderate-or-

above intensity P.A. into MET-minutes. According to the “American

Indicator”, adults and the elderly who accumulated at least 150 minutes

moderate-or-above intensity P.A. in a week (or 75minutes vigorous

intensity P.A. or other combinations of different intensities, e.g.

accumulation of 90 minutes and 30 minutes moderate- and vigorous-

intensity P.A. respectively) were classified as physically active. To

facilitate the further analysis, the original categories “active” and

“inactive” were subdivided into “highly active”, “active”, “some active”,

and “sedentary” (see the table below). Less than 30% of adults and the

elderly were categorized as having sufficient P.A. (highly active and

active levels) in each age group. For almost every two adults, one of them

was found sedentary.

Category

(with modification)

Accumulation of moderate-

or-above intensity physical

activity in a week

Age (%) Total

(%) 20–39 40–59 60–69

IV Highly active ≥ 300 minutes 14.7 16.3 16.7 15.7

III Active 150–299 minutes 13.8 12.2 12.6 12.9

II Some active 31–149 minutes 26.4 20.5 18.6 22.7

I Sedentary ≤ 30 minutes 45.1 51.0 52.1 48.7

7.4.2 On the other hand, a classification according to the “Baseline Indicator”

was shown in the table below. Adults and the elderly who participated in

moderate-or-above intensity P.A. at least three days a week with

accumulation of 30 minutes or above per day were classified as physically

active. 37.1% of adults and the elderly were “active”. 41.3% of men were

“active”, 7.7 percent points higher than the prevalence in women.



Boys

(%)

Girls

(%)

Total

(%)




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7.4.3 The majority of adults and the elderly (71.1%) slept 7 hours or more but

less than 9 hours per day on working or school days. There were 5.5%

sleeping less than 6 hours per day. People slept about 7.46 hours on

average.

7.4.4 The four major activities engaged in leisure time were “audio/ video

entertainment” (63.0%), “shopping” (45.2%), “browsing on the internet”

(40.2%), and “sports/ physical exercise” (27.6%).

7.4.5 In adults and the elderly, the average walking time per day was 84.90

minutes. More than 60% of them (62.0%) walked less than 120 minutes.

On the other hand, the average sitting time per day was 7.01 hours.

7.4.6 More than 50% of samples (52.3%) took part in sports activities for

“health strengthening/ prevention or cure of sickness”. As high as a

quarter of young adults (27.5%) did not have any involvement in sports

activities. The prevalence of other two age groups got even higher

(middle-aged: 35.7%, elderly: 32.5%). The situation raised awareness.

More and more people lost interests in playing sports as getting older. The

percentage of unsuitability to participate for health concern also increased

with age.

7.4.7 The three major barriers to sports activities participation were “lack of

spare time” (62.9%), “tired”(37.9%), and “lazy” (33.5%). 71.5% of young

adults expressed that they did not have spare time to take part in sports

activities. This barrier contributed a relatively smaller proportion to other

age groups (middle-aged: 61.2%, elderly: 40.8%).

7.4.8 The most frequently participated sports activities were “ball games”

(40.4%) and “running/ jogging” (36.9%) in young adults. “Walking”

become more popular and got the first place in the elderly (51.4%). As age

increased, physically demanding activities or those involving body-contact

lost popularity. Walking was more preferable for the elderly.


Main Effects and Interaction Effect of Gender and Age-Groups on Physical Fitness

7.5.1 In 2-way ANOVA, significant main effects (age-groups and gender) and

interaction effect (gender × age-groups) were found on physical fitness.

For exercise measurements, men performed better in handgrip, 1-min sit-

ups, push-ups, vertical jump, closed eyes balance stand, reaction time, and

3-min step test than women except for the sit-and-reach test. The overall

fitness level significantly decreased with age in both genders.

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7.5.2 These results suggest that women decline in fitness parameters (including

resting SBP and DBP, BMI, waist circumference, hip circumference,

percent body fat, handgrip, estimated VO2 max, and step test recovery HR

in 3-min step test) much quicker than men from young adult to middle

aged and carry over to older adult years. More attention was suggested to

promote health-related fitness of women.


Indicator”) in Adults & the Elderly

7.5.3 Significant differences in many physical fitness parameters were found

amongst the three P.A. levels in both genders. Men with “sufficient P.A.”

(active and highly active) possessed lower resting HR and waist-to-hip

ratio, higher cardiovascular fitness, flexibility, forearm strength and

abdominal endurance, and shorter reaction time, but larger BMI. In

addition, men having “sufficient” or “some P.A.” (some active) both had

greater leg strength and muscular endurance at shoulders, upper back, and

pectorals.

7.5.4 Sedentary group generally possessed lower physical fitness level.

7.5.5 Women had similar findings as men.

Relationship between Family Income and Physical Activity Level (“American

Indicator”)

7.5.6 Family income was found to be highly correlated with the P.A. level.

40.0% of men whose family income was higher than the median income

were “active”. Such prevalence was higher than those below the median

income (28.7%). In other words, more physically active men were found

in family with higher income.

7.5.7 On the contrary, family income did not indicate a significant relationship

with the P.A level of women.

Relationship between Smoking Status and Physical Fitness

7.5.8 Significant differences were found in several physical fitness parameters

between smokers and non-smokers in men. The sampling error may be

high as the number of female smoking participants was so small.

Therefore significant difference in fitness profiles could not be easily

defined between female smokers and non-smokers.

7.5.9 In men, non-smokers possessed smaller waist-to-hip ratio, larger leg

strength, better balance-controlling ability, and shorter reaction time.

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Relationship between Occupations and Physical Activity Level (“American

Indicator”)

7.5.10 Types of occupations were highly correlated with employee’s P.A. level.

7.5.11 The occupation with highest proportion of “active” level was professionals

(47.9%) in men and managers or administrators (34.8%) in women.

Relationship between Physical Fitness and Educational Attainment

7.5.12 Significant differences were found in many physical fitness parameters

among various groups of educational attainment in both genders. Women

with tertiary education level had thinner skinfold, better cardio-respiratory

fitness (in terms of estimated VO2 max), and larger abdominal endurance

and leg strength. Moreover, women with higher levels of education had

smaller BMI, percent body fat, chest circumference, waist circumference,

hip circumference, and waist-to-hip ratio, lower resting SBP and DBP,

greater handgrip strength and balance-controlling ability, and shorter

reaction time. More desirable fitness level may be attributed to their

consciousness of health and fitness.

7.5.13 Men had similar findings but not such obviously among different

education levels existed in women. Significant differences were involved

in some fitness parameters mainly between secondary level and tertiary

level of education. That is, men with tertiary education attainment were

found to better fitness level (including lower BMI, percent body fat, and

resting DBP, as well as greater muscular endurance at abdomen and

strength at lower limbs) than those having secondary level of education.




and the current study. The proportion of “active” adults and elderly

dropped significantly from 43.5% to 37.0% in these two years. Such

results were attributed to a significant decrease in the prevalence by 8.7

percent points in men and 4.2 percent points in women being classified as

physically active.



2009 56.5 43.5 0.000 @

2011 63.0 37.0 @


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7.5.15 On the other hand, the P.A. level based on “American Indicator”

classification was compared between “Sports for All Study 2009” and the

current study (see the table below). There was no significant difference in

P.A. level between them. The prevalence of being “active” stayed within

28% and 30%.



2009 70.7 29.3 0.471

2011 71.6 28.4

Preliminary Study on the “Sport For All Day”

7.5.16 Close to half of the respondents (46.4%) heard about the arrangement of

the “Sport for All Day”. Significant difference was observed among

different age groups that 53.7% of young adults heard about the event,

22.9 percent points higher than the elderly as shown in the table below.

Heard about the “Sport

For All Day” Before

Age (%) Total

(%)

Chi-square Test

p-value 20–39 40–59 60–69

Yes 53.7 44.1 30.8 46.4 0.000

@

No/ Not sure 46.3 55.9 69.2 53.6


7.5.17 12.2% of the respondents who were aware of the “Sport for All Day”

participated in the event. No significant difference was observed among

different age groups as shown in the table below.

Participation in the

“Sport For All Day”

Age (%) Total

(%)

Chi-square Test

p-value 20–39 40–59 60–69

Yes 13.7 10.8 10.5 12.2 0.513

No/ Not sure 86.3 89.2 89.5 87.8

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7.5.18 As much as 60.4% of “Sport for All Day” participants thought that their

interests in sports and P.A. could be raised through the participation. No

significant difference was found among different age groups as shown in

the table below.

Increase Interests in

Sports and P.A.

Age (%) Total

(%)

Chi-square Test

p-value 20–39 40–59 60–69

Yes 57.3 60.8 81.4 60.4 0.403

No 42.7 39.2 18.6 39.6


7.6.1 It is important to provide not only all-around education on the relationship

between physical activity and health to schoolchildren, but also a regular

delivery of related messages, including simple concepts of exercise

training, health risks associated with inactivity, etc. For example, it is

necessary for all ages to learn how to use BMI for overweight and obese

classification, in addition to the idea of central obesity. It can be a

breakthrough point to alleviate the rapid expansion of obesity. Another

example is regular checking of blood pressure. In this Study, results

showed that the prevalence of hypertensive response kept on increasing

throughout the adulthood. A sharp rise in having hypertension was also

observed in women. However, “Population Health Survey 2003/2004”

found that less than two-thirds of people (62.9%) had their blood pressure

checked by health professionals from year 1999 to 2004. In those who had

the blood pressure checking, 21.2% performed it once for more than 12

months. Making people more self-conscious about the universal and

comparable standards as well as helping them take the initiative to develop

an active lifestyle are always the most effective strategies.

7.6.2 In the current study, 81.9% of men and 58.1% of women were currently

engaged in employment, including full-time and part-time job. They spent

47.75 hours on average per week. 11.0% of them worked even 60 hours or

above. 28.3% of adults and the elderly had not retired yet. The workplace

nowadays is no doubt a second home for many people. It is suggested that

employers provide their employees with simple physical activities in the

workplace or arrange regular recreation sports activities to them and their

family members. It can help raise employees’ P.A. level as well as

promoting their sense of belonging to the company.

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7.6.3 Results showed that at least one person was classified as either of

overweight or obese for every two men. Even as high as 40.8% of elderly

women experienced the problem of obesity. According to “American

Indicator”, 71.6% of adults and the elderly did not have sufficient P.A. to

sustain healthy body. Enormous economic and medical costs will be

incurred if no further actions are taken. Related stakeholders can

encourage sedentary people to have moderate-or-above intensity P.A. at

least three days a week with accumulation of 30 minutes or above per day.

In other words, sedentary people are advised to take a first step to meet

“Baseline Indicator”. For those who have already met the basic

requirement, they were suggested to gradually increase their P.A. level

and ultimately achieve 150 minutes moderate-or-above intensity P.A. On

the other hand, related stakeholders were also recommended to install the

concepts of energy balancing in the public at various levels, including the

implementation of food labelling policy, standardized recommendations

for daily intake by authority such as universities and professional

dieticians, and exercise training principles instructed by qualified fitness

instructors.

7.6.4 As much as 66.5% and 48.4% of middle-aged men and women

respectively encountered overweight or obesity. The situation raised

awareness in the society. It is common that the middle-aged are busy at

work and find difficulty in sparing time to take part in P.A., which

involves with standardized requirements on the number of participants,

time, and venue, etc. Related stakeholders may consider organizing some

kind of activities, which only require simple equipment and are not

restricted by time, say jogging and walking. Other possible activities

suitable for middle-aged people include gateball, lawn bowls, hydro-

fitness, and stretching exercise. The middle-aged can alleviate pressure

from work and daily life via making full of the opportunities to engage in

more physical activities. On the other hand, it is suggested that business

companies design some fitness areas for exercise so as to help employees

incorporate a regular exercise habit into workplace.

7.6.5 In adults and the elderly, “walking”, “running/ jogging”, “ball games”,

“swimming”, and “hiking” were the top five popular sports activities.

Exercise promotion programs such as walking fun days and family ball

games carnivals can be organized periodically at the venues managed by

related stakeholders.

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7.6.6 Evidence showed that the general fitness level of women declined much

faster than men across their adulthood in the current study. It is necessary

to promote healthy and active lifestyle to women. Related stakeholders

may consider organizing more exercise and recreational programs that are

appealing to women, such as dancing, hydro-fitness, Tai Chi, fit ball,

Thera-band exercise …etc.

8 Conclusion

8.1 The fact that weight problem straddles various age groups is a matter of concern..

According to “Global Strategy on Diet, Physical Activity and Health” released by

WHO in 2004, regular P.A. and balanced diet had substantial influence on human

health. They both helped control the calories intake and retrieve the problem of

obesity.

8.2 Educators were suggested to take reference from the guidelines prepared by EDB

and the Department of Health to improve the inactivity in children. A Physical

Education curriculum covering a great variety of physical activities through

different learning experiences was needed to provide students with more options.

Moreover, it was recommended that related stakeholders offer education to parents

who had the responsibility to encourage and support their children to participate in

P.A. Community resources could also be further utilized so as to enrich the

opportunities of non-school based physical activities for children.

8.3 Men generally fared better than women in all age groups in terms of physical fitness

level. After reaching adulthood, both genders registered significant drop in fitness

level and increase in exposure to various health risks (obesity, high BP, and low

cardiovascular fitness) as age increased. Meanwhile, women’s fitness was also

found to have diminished much faster than men’s. Related stakeholders were

suggested to strengthen education and publicity in order to enhance people’s

cognition in physical fitness as well as their alertness against health risks.

8.4 Fitness level and P.A. participation were also found to have a different degree of

correlation with the living habits such as sleeping time, screen time, parents’ rate of

participation in P.A., and education attainment. It follows that personal lifestyle, if

carefully adjusted, could raise people’s fitness level and P.A. level. The proposed

adjustments include sufficient time for sleeping (neither too many nor too few),

reduction in sedentary activities, increase in family-oriented P.A., start of keeping a

balanced diet as young as possible, and regular updating of fitness-related

information, etc.

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8.5 Results showed that high correlations only existed between limited numbers of

fitness parameters. In other words, every parameter had its unique characteristics

and measurement value. It was recommended to include as more test items as

possible so as to project a realistic fitness profile.

8.6 Hong Kong people were encouraged to gradually develop an active lifestyle starting

from “Baseline Indicator” which emphasized the participation in moderate-or-above

intensity P.A. at least three days a week with accumulation of 30 minutes or above

per day. Research team also pointed out a dose-effect relationship between P.A.

levels and health benefits. Everyone should therefore avoid inactivity. Having

limited physical activities were stills said to be better than nothing done.

Participation in any P.A. would always bring you some health benefits. The long-

term goal was to achieve recommendations stated in “American Indicator”. That is,

for children, to accumulate at least 60 minutes moderate-or-above intensity P.A.

every day in a week; for adolescents, to accumulate at least 60 minutes moderate-

or-above intensity P.A. every day in a week in which any three days involved with

vigorous intensity P.A.; for adults and the elderly, to accumulate at least 150

minutes moderate-or-above intensity P.A. in a week (or 75minutes vigorous

intensity P.A. or other combinations of different intensities and durations). People

who had not taken part in P.A. for some time, and those with chronic diseases or

being at high risks for these problems should consult their doctors before embarking

on an exercise training programme.

8.7 To conclude, findings indicate no significant rise but a slight drop in the overall P.A.

level of Hong Kong people (except for girls aged 7 to 12) in the past two years

according to “Baseline Indicator” and “American Indicator”. One of the reasons

may be the occurrence of major sports events. The data collection period of “Sports

for All Study 2009” was mainly in year 2008 in which Beijing hosted Olympic

Games and Hong Kong co-organized the equestrian competition. At the same time,

Hong Kong also actively prepared for the first regional multi-sport event “2009

East Asian Games”. The government devoted resources to popularize the event with

the support of the mass media. The passionate atmosphere for physical activities

was developed as a result. People may easily get in touch with the exercise and

sports as well as yielding interests in participation, raising the P.A. level. Since the

Games were all over, the atmosphere cooled down and the P.A. level may decrease

eventually.

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8.8 Since 1995, the Government of the People’s Republic of China announced the

National policy “全民健身計劃綱要” and has determined “Fitness for All” as their

national health objective. Since then significant education and researches are

actively implemented throughout the country. The United States has established a

government funded and independent agency called the “National Coalition for

Promoting Physical Activity (NCPPA)” as a result of the release of the Surgeon

General Report on Physical Activity and Health (1996). Increasing the P.A. level

became the top priority of their national health goal, followed by obesity reduction

and smoking cessation. Professional bodies like the American College of Sports

Medicine, American Heart Association, and President Challenge for Physical

Fitness Council jointed the NCPPA for implementing nationwide P.A. promotion to

emphasize the importance of regular P.A. To learn from these experiences, we may

set citywide health objectives in Hong Kong and put increasing the P.A. level as

one of our top priority. The Study is the first scientific-based survey which aimed to

investigate Hong Kong people’s fitness level and P.A. participation pattern using

random sampling. It provided an enormous database to help define the directions

and strategies. Once objectives are established, evaluation can be easily made in

future to see whether our existing resources are effective to achieve the health

objectives.

- END -

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